August 16, 2013
This week, the California Dental Association (CDA), together with several of its members, filed a demand for arbitration with Delta Dental of California (California Delta).
The arbitration demand seeks to prevent the effectiveness of California Delta’s announced changes to its agreement with dentists (1) revising the contractual provision concerning arbitration, and (2) deleting a provision in the current California Delta contract that California Delta would only lower its maximum amount payable if “participating dentists’ filed or submitted fees decrease to such an extent that Delta is warranted in reducing the maximum amount allowed.” The central issue in the legal proceeding is likely to be whether this distinct justification language from the California Delta agreement can be modified.
California Delta’s arbitration revision would narrow the availability of arbitration to disputes concerning payments, overpayments and refund requests. California Delta’s current provision allows arbitration of disputes concerning fee filings and contracting issues, as well.
The form of such agreements varies state by state. The Washington Dental Service form of agreement does not contain such justification language. Nor is there any available arbitration for fee filings in Washington.
The WSDA will follow the proceeding with interest. WSDA members who wish more information about the matter may contact Alan Wicks, WSDA general counsel, at (206) 973-5238.